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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Recent years have seen a progressive increase in the incidence of sexually transmitted infections &#40;STIs&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Since the French scientists Barr&#233;-Sinoussi and Luc Montagnier identified the human immunodeficiency virus &#40;HIV&#41; as the causative agent of AIDS in 1983 and cases were reported worldwide&#44; awareness programs and information campaigns have been developed to help prevent unsafe sexual practices&#46; Although more than 95&#37; of patients present skin manifestations during the course of the disease&#44; in the vast majority of cases these occur in advanced stages&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Because dermatologists frequently manage the diagnosis and treatment of patients who consult for an STI or risky sexual contact&#44; it is important that they perform serology for early detection of primary HIV infection in these patients&#46; In this study we quantify new diagnoses of HIV infection made in a dermatology department and describe the corresponding clinical and epidemiological characteristics&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Data on all cases of new HIV diagnoses made between July 2016 and July 2019 in the dermatology department of Hospital General Universitario de Valencia were obtained from the department&#39;s STI database&#46; Early diagnosis was defined as a CD4 count &#62;350 cells&#47;&#181;L in the first tests performed after diagnosis of HIV infection&#59; late diagnosis as a CD4 count &#60;350 cells&#47;&#181;L&#59; and advanced disease as a CD4 count &#60;200 cells&#47;&#181;L&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A total of 18 new HIV diagnoses were established during the 3-year study period&#44; accounting for 1&#46;9&#37; of the total number of STIs diagnosed &#40;n&#8239;&#61;&#8239;940&#41;&#46; The clinical and epidemiological characteristics of the patients are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Twelve of the cases &#40;66&#46;7&#37;&#41; were diagnosed in the screening analysis performed when the patient consulted for an STI&#46; In 2 cases&#44; the diagnosis was not associated with any other concomitant disease or STI&#46; In these 2 cases&#44; both patients presented with acute retroviral syndrome associated with general malaise&#44; asthenia&#44; and a generalized morbilliform macular rash with palmar&#8211;plantar involvement that had begun 2 weeks earlier &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Both had normal CD4 lymphocyte counts&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">According to the Spanish National Registry of HIV and AIDS Cases &#40;updated June 30&#44; 2019&#41;&#44; 3244 new HIV diagnoses were reported in 2018&#44; corresponding to a rate of 6&#46;94 per 100000 inhabitants without correcting for reporting delays and 8&#46;65 per 100000 inhabitants after correction&#46; Patients aged less than 30 years at the time of HIV diagnosis accounted for 27&#46;7&#37; of cases &#40;n&#8239;&#61;&#8239;898&#41;&#46; Men accounted for 85&#46;3&#37; of cases and the median age was 36 years&#44; in agreement with the demographic profile of our series&#46; The highest proportion of cases &#40;83&#46;3&#37;&#41; occurred in men who have sex with men &#40;MSM&#41;&#46; This percentage was slightly higher than that reported in the National Registry of HIV and AIDS Cases &#40;56&#46;4&#37;&#41;&#44; probably due to the fact that patients in our cohort consulted at an STI unit in our hospital&#46; In Spain&#44; non-Spanish nationals account for 37&#46;6&#37; of new HIV infection diagnoses&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> a slightly higher percentage than that observed in our series&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">It is rare for large series of patients to be diagnosed with de novo HIV infection in a dermatology department&#46; Mendes-Bastos et al&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> dermatologists from Lisbon&#44; Portugal&#44; diagnosed 97 de novo cases of HIV infection in 9 years of follow-up&#44; corresponding to almost 11 cases per year&#46; This rate is higher than that reported in our series&#44; possibly because HIV prevalence in Portugal is among the highest in western Europe&#46; In that series&#44; approximately half of the patients were diagnosed with a concomitant STI&#44; compared with two-thirds of patients in our series&#46; It is thought that diagnosis is established earlier and viral loads are lower in cases involving a concomitant STI versus a concomitant non-STI disease<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#58; in the former scenario diagnosis is established based on serological screening&#44; while patients that present with concomitant non-venereal diseases&#44; such as Kaposi sarcoma or bacillary angiomatosis&#44; are usually already in an advanced state of immunosuppression&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Some authors have highlighted the importance of dermatology and venereology in the diagnosis of new HIV cases&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> although to date there are no concrete data available for most regions of the world&#46; It should be borne in mind that many patients who visit the emergency department with a suspected STI do not return for follow-up visits&#44; and therefore may not be informed of their HIV diagnosis&#46; Mendes-Bastos et al estimate that 12&#37; of patients in their series who were diagnosed with de novo HIV infection did not return&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> underscoring the importance of extracting blood samples at the first visit of all patients who present to the emergency department with a STI&#44; even those with condylomata acuminata&#44; and of scheduling follow-up according to the potential HIV window period in cases of infections with a short incubation period&#44; such as gonococcal urethritis&#46; This approach should also be extended to patients with lesions typically associated with HIV or with atypical or exuberant presentations of other diseases &#40;e&#46;g&#46; psoriasis&#44; prurigo nodularis&#44; seborrheic dermatitis&#44; atopic dermatitis&#44; herpetic infections&#44; esophageal candidiasis&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In our experience&#44; dermatologists continue to play an important role in the diagnosis both of STIs and de novo HIV infections&#44; as they are often the first point of contact for these patients within the healthcare system&#46; Furthermore&#44; dermatologists are well positioned to offer and prescribe recently developed pre-exposure prophylactics&#44; applying inclusion criteria that are fulfilled by a large proportion of patients who present at STI units &#40;MSM aged over 18 years who have or have had anal sex without a condom with at least 10 different individuals in the preceding year and at least 1 episode of a bacterial STI in the preceding 12 months&#41;&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0040" class="elsevierStylePara elsevierViewall">No funding was received for this study&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of Interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; MSM&#44; men who have sex with men&#59; STI&#44; sexually transmitted infection&#46;</p>"
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">17 &#40;94&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mean age&#44; y&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">37&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Region of Nationality</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">13 &#40;72&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4 &#40;22&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
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                  \t\t\t\t">Sexual orientation</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>MSM&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">15 &#40;83&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Casual diagnosis after laboratory test&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;88&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
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                  \t\t\t\t">Associated diagnosis &#40;n&#8239;&#61;&#8239;16&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Syphilis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7 &#40;38&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Kaposi sarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Condylomata acuminata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;11&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Gonococcal urethritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;11&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Lymphogranuloma venereum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14 &#40;77&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">12 &#40;66&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                          "etal" => true
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Case and Research Letters
Diagnosis of De Novo HIV Infection in a Dermatology Department
Diagnóstico de VIH de novo en un Servicio de Dermatología
J. Magdaleno-Tapial
Corresponding author
jormagta@gmail.com

Corresponding author.
, P. Hernández-Bel, C. Valenzuela-Oñate, A. Pérez-Ferriols
Department of Dermatology, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
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it is important that they perform serology for early detection of primary HIV infection in these patients&#46; In this study we quantify new diagnoses of HIV infection made in a dermatology department and describe the corresponding clinical and epidemiological characteristics&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Data on all cases of new HIV diagnoses made between July 2016 and July 2019 in the dermatology department of Hospital General Universitario de Valencia were obtained from the department&#39;s STI database&#46; Early diagnosis was defined as a CD4 count &#62;350 cells&#47;&#181;L in the first tests performed after diagnosis of HIV infection&#59; late diagnosis as a CD4 count &#60;350 cells&#47;&#181;L&#59; and advanced disease as a CD4 count &#60;200 cells&#47;&#181;L&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A total of 18 new HIV diagnoses were established during the 3-year study period&#44; accounting for 1&#46;9&#37; of the total number of STIs diagnosed &#40;n&#8239;&#61;&#8239;940&#41;&#46; The clinical and epidemiological characteristics of the patients are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Twelve of the cases &#40;66&#46;7&#37;&#41; were diagnosed in the screening analysis performed when the patient consulted for an STI&#46; In 2 cases&#44; the diagnosis was not associated with any other concomitant disease or STI&#46; In these 2 cases&#44; both patients presented with acute retroviral syndrome associated with general malaise&#44; asthenia&#44; and a generalized morbilliform macular rash with palmar&#8211;plantar involvement that had begun 2 weeks earlier &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Both had normal CD4 lymphocyte counts&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">According to the Spanish National Registry of HIV and AIDS Cases &#40;updated June 30&#44; 2019&#41;&#44; 3244 new HIV diagnoses were reported in 2018&#44; corresponding to a rate of 6&#46;94 per 100000 inhabitants without correcting for reporting delays and 8&#46;65 per 100000 inhabitants after correction&#46; Patients aged less than 30 years at the time of HIV diagnosis accounted for 27&#46;7&#37; of cases &#40;n&#8239;&#61;&#8239;898&#41;&#46; Men accounted for 85&#46;3&#37; of cases and the median age was 36 years&#44; in agreement with the demographic profile of our series&#46; The highest proportion of cases &#40;83&#46;3&#37;&#41; occurred in men who have sex with men &#40;MSM&#41;&#46; This percentage was slightly higher than that reported in the National Registry of HIV and AIDS Cases &#40;56&#46;4&#37;&#41;&#44; probably due to the fact that patients in our cohort consulted at an STI unit in our hospital&#46; In Spain&#44; non-Spanish nationals account for 37&#46;6&#37; of new HIV infection diagnoses&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> a slightly higher percentage than that observed in our series&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">It is rare for large series of patients to be diagnosed with de novo HIV infection in a dermatology department&#46; Mendes-Bastos et al&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> dermatologists from Lisbon&#44; Portugal&#44; diagnosed 97 de novo cases of HIV infection in 9 years of follow-up&#44; corresponding to almost 11 cases per year&#46; This rate is higher than that reported in our series&#44; possibly because HIV prevalence in Portugal is among the highest in western Europe&#46; In that series&#44; approximately half of the patients were diagnosed with a concomitant STI&#44; compared with two-thirds of patients in our series&#46; It is thought that diagnosis is established earlier and viral loads are lower in cases involving a concomitant STI versus a concomitant non-STI disease<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#58; in the former scenario diagnosis is established based on serological screening&#44; while patients that present with concomitant non-venereal diseases&#44; such as Kaposi sarcoma or bacillary angiomatosis&#44; are usually already in an advanced state of immunosuppression&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Some authors have highlighted the importance of dermatology and venereology in the diagnosis of new HIV cases&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> although to date there are no concrete data available for most regions of the world&#46; It should be borne in mind that many patients who visit the emergency department with a suspected STI do not return for follow-up visits&#44; and therefore may not be informed of their HIV diagnosis&#46; Mendes-Bastos et al estimate that 12&#37; of patients in their series who were diagnosed with de novo HIV infection did not return&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> underscoring the importance of extracting blood samples at the first visit of all patients who present to the emergency department with a STI&#44; even those with condylomata acuminata&#44; and of scheduling follow-up according to the potential HIV window period in cases of infections with a short incubation period&#44; such as gonococcal urethritis&#46; This approach should also be extended to patients with lesions typically associated with HIV or with atypical or exuberant presentations of other diseases &#40;e&#46;g&#46; psoriasis&#44; prurigo nodularis&#44; seborrheic dermatitis&#44; atopic dermatitis&#44; herpetic infections&#44; esophageal candidiasis&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In our experience&#44; dermatologists continue to play an important role in the diagnosis both of STIs and de novo HIV infections&#44; as they are often the first point of contact for these patients within the healthcare system&#46; Furthermore&#44; dermatologists are well positioned to offer and prescribe recently developed pre-exposure prophylactics&#44; applying inclusion criteria that are fulfilled by a large proportion of patients who present at STI units &#40;MSM aged over 18 years who have or have had anal sex without a condom with at least 10 different individuals in the preceding year and at least 1 episode of a bacterial STI in the preceding 12 months&#41;&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0040" class="elsevierStylePara elsevierViewall">No funding was received for this study&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of Interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Magdaleno-Tapial J&#44; Hern&#225;ndez-Bel P&#44; Valenzuela-O&#241;ate C&#44; P&#233;rez-Ferriols A&#46; Diagn&#243;stico de VIH de novo en un Servicio de Dermatolog&#237;a&#46; Actas Dermosifiliogr&#46; 2021&#59;112&#58;932&#8211;934&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Acute antiretroviral syndrome with morbilliform erythematous macular rash on the trunk &#40;A&#41; and palms &#40;B&#41;&#46;</p>"
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          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; MSM&#44; men who have sex with men&#59; STI&#44; sexually transmitted infection&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number of Cases&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;94&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mean age&#44; y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Region of Nationality</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Spain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;72&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Latin America&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;22&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Africa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexual orientation</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>MSM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;83&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Heterosexual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Casual diagnosis after laboratory test&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;88&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associated diagnosis &#40;n&#8239;&#61;&#8239;16&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Syphilis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;38&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Kaposi sarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Condylomata acuminata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;11&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Gonococcal urethritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;11&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bacillary angiomatosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Lymphogranuloma venereum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Emergency dermatological consultation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;77&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>History of previous STIs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;66&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stage at diagnosis</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Early diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;77&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Late diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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Article information
ISSN: 15782190
Original language: English
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Idiomas
Actas Dermo-Sifiliográficas
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